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Flashcards in 560A PATHOPHYSIOLOGY Deck (169)
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1
Q

Apoptosis is

a) genetically programmed self-destruction of cells
b) a condition characterized by a lack of blood flow
c) the loss of a cell’s ability to divide after injury
d) typically reversible
e) programmed elongation of a cell to avoid the effects of radiation

A

A

2
Q

The condition in which mature, competent helper T cells from a donor orchestrate an immune response directed against recipient tissues is

a) immediate hypersensitivity
b) graft vs. host disease
c) hyperacute rejection
d) host vs. graft disease
e) chronic rejection

A

B

3
Q

An infarct is caused by

a) trauma
b) poisoning
c) endogenous physical agents
d) anoxia
e) a deficiency of dietary factors

A

D

4
Q

A characteristic problem in osteoporosis is

a) cartilage degeneration
b) focal infection
c) pathologic fractures
d) atrophy of epiphyseal plates
e) looseness of the joints

A

C

5
Q

A lumbar puncture

a) may produce a mild headache
b) may be performed between L3 and L4
c) draws CSF from the extradural space
d) often traumatizes spinal nerves
e) is performed near the vertebra prominens

A

b) may be performed between L3 and L4

6
Q

Which of the following would be most likely to result in respiratory alkalosis?

a) kidney disease
b) hyperventilation
c) overuse of antacids
d) chronic obstructive pulmonary disease (COPD)

A

b) hyperventilation

7
Q

What are the benefits of EPA/DHA?

A

Reduces inflammation, eases joint pain, antidepressive benefits, improves insulin sensitivity, reduces cardiovascular risk, lowers blood pressure and triglycerides

8
Q

What are the ABCDs of a nutritional exam?

A

Anthropometric, Biochemical, Clinical, Dietary

9
Q

What is the difference between arteriosclerosis and atherosclerosis?

A

Arteriosclerosis is the stiffening or hardening of the artery walls. Atherosclerosis is the narrowing of the artery because of plaque build-up.

10
Q

What is MTHFR?

A

Methylenetetrahydrofolate reductase, an enzyme needed to metabolize homocysteine; a genetic mutation that may lead to high levels of homocysteine in the blood and low levels of folate and other vitamins.

11
Q

What does the ratio of reduced glutathione (GSH) to oxidized glutathione (GSSH) within cells measure?

A

Level of oxidative stress

12
Q

In healthy cells and tissue, more than 90% of the total glutathione pool is in the _____ form (GSH), with the remainder in the _____ form (GSSG). A(n) _____ GSSG-to-GSH ratio is indicative of oxidative stress.

Options: reduced, decreased, oxidized, increased

A

Reduced, oxidized, increased

13
Q

What converts oxidized glutathione (GSSH) to the reduced form (GSH), and which enzyme catalyzes this conversion?

A

NADPH, glutathione reductase

14
Q

What is the range for normal blood pH?

A

7.35-7.45

15
Q

Which blood pH indicates acidosis?

A

Below 7.35

16
Q

Which blood pH indicates alkalosis?

A

Above 7.45

17
Q

At the normal pH of 7.40, the ratio of bicarbonate to carbonic acid buffer is:

A

20:1

18
Q

When does metabolic acidosis occur, and what is the cause?

A
19
Q
The most selective antimicrobial activity (toxic to bacteria but little or no effect on human cells) would be exhibited by a drug that:
A. inhibits cell wall synthesis.
B. inhibits protein synthesis.
C. injures the plasma membrane.
D. inhibits nucleic acid synthesis.
A

A. inhibits cell wall synthesis.

20
Q

Infections with viruses cause various clinical manifestations. Which of the following is NOT a manifestation of a virus infection?
A. The virus damages or destroys infected cells.
B. Formation of inclusion bodies in infected cells
C. Production of endotoxins
D. The virus causes proliferation of infected cells.
E. The virus infects cells but causes only an asymptomatic (latent) infection.

A

C. Production of endotoxins

21
Q
Coccidioidomycosis is generally an acute, self-limited respiratory infection that subsides without treatment, but a more serious, chronic progressive form is often encountered in:
A. teenagers
B. young male adults
C. immunocompromised persons
D. middle-aged females
A

C. immunocompromised persons

22
Q
An immunoglobulin found in blood that is a clump of five molecules (a pentamer) is:
A. IgM
B. IgG
C. IgA
D. IgD
E. IgE
A

A. IgM

23
Q
Autoimmune diseases are caused by \_\_\_\_\_\_\_\_\_\_.
A. autoantibodies
B. non-self-antigens
C. self-antigens
D. cytokines
A

A. autoantibodies

24
Q

Which of the following describes an atopic person?
A. An individual with a low T-cell count
B. An individual with a disease of the immune system
C. An individual who is prone to having allergies
D. An individual who rarely has an allergy
E. None of the above

A

C. An individual who is prone to having allergies

25
Q
\_\_\_\_\_\_\_\_\_\_ are antibodies produced by plasma cells.
A. Immune-response genes
B. Interleukins
C. Interferons
D. Immunoglobulins
E. Complements
A

D. Immunoglobulins

26
Q

Which of the following is NOT a characteristic used to classify bacteria?
A. Biochemical and cultural characteristics
B. Shape
C. Antigenic structure
D. Virulence
E. Gram-stain reaction

A

D. Virulence

27
Q
\_\_\_\_\_\_\_\_\_\_ are chemical messengers that take part in any function of the immune system.
A. Lymphokines
B. Monokines
C. Cytokines
D. Interleukins
E. natural killer cells
A

C. Cytokines

28
Q
Which of the following is an antiviral substance produced by virus-infected cells?
A. Acyclovir
B. AZT
C. Immunoglobin (antibodies)
D. Interferon
E. Histamine
A

D. Interferon

29
Q

Plasma cells make antibodies.
True
False

A

True

30
Q

The immune defenses of the host are activated as viruses that invade cells produce new antigens and the body recognizes these cells as foreign.
True
False

A

True

31
Q

Cellular immunity is associated with formation of antibodies that can combine with and eliminate an antigen; the major defense against bacteria and bacterial toxins.
True or False

A

False

32
Q

A carcinoma arises from surface, glandular or parenchymal epithelial tissues; a sarcoma arises from other primary tissues.
True
False

A

True

33
Q
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ is characterized by excessive absorption of iron, which accumulates within the body and disrupts organ functions.
A. Sickle cell anemia
B. Tay-Sachs disease
C. Hemophilia
D. Hemochromatosis
E. Phenylketonuria
A

D. Hemochromatosis

34
Q

What is a neoplasm of blood cells?

A

Leukemia

35
Q

A mother has given birth to an infant with cytomegalic inclusion disease; what does this indicate?
A. The infant is likely to have an abnormal chromosome karyotype.
B. The mother has been previously infected with CMV and the infection became activated during pregnancy, or the mother acquired a CMV infection during her pregnancy.
C. There is no risk of fetal injury or malformation, because the mother can not transmit CMV to the fetus.
D. The virus may have caused genetic abnormalities in the fetal chromosomes, which can be identified by lab tests.

A

B. The mother has been previously infected with CMV and the infection became activated during pregnancy, or the mother acquired a CMV infection during her pregnancy.

36
Q

The function of lysosomes is to:
A. Break down particles or worn-out cellular components
B. Convert food materials into energy
C. Produce digestive enzymes and antibody proteins
D. Aid in cell division
E. Provide framework to the cell

A

A. Break down particles or worn-out cellular components

37
Q

Choose the answer below that best completes the sentence: DNA is composed of __________ base chemicals called __________.
A. 4; adenine, thymine, guanine, cytosine
B. 3; nucleotide, deoxyribose, base
C. 2: chromosomes, proteins
D. 3: ectoderm, entoderm, mesoderm
E. two strands of RNA held together by weak chemical bonds

A

A. 4; adenine, thymine, guanine, cytosine

38
Q
Examining diseased tissue with a microscope is called a \_\_\_\_\_\_\_\_ examination.
A. gross
B. histological
C. physical
D. cellular
E. pathological
A

B. histological

39
Q
What is the definitive diagnostic method to identify a pulmonary embolism?
A. Pulmonary angiogram
B. Radioisotope lung scan
C. Chest x-ray
D. Catheterization of the lungs
E. Blood test
A

A. Pulmonary angiogram

40
Q

Which is not one of the five factors that affects hemostasis?
A. Normal amounts of coagulation factors
B. Integrity of the small blood vessels
C. Adequate numbers of structurally and functionally normal platelets
D. Adequate supply of potassium ions
E. Normal amounts of coagulation inhibitors

A

D. Adequate supply of potassium ions

41
Q

Which of the following statements relating to congestive failure is INCORRECT?
A. It may follow any type of heart disease.
B. Venous pressure is elevated.
C. It leads to excretion of excessive amounts of salt and water by the kidneys.
D. Blood volume is increased.
E. Edema of tissues often occurs

A

C. It leads to excretion of excessive amounts of salt and water by the kidneys.

42
Q

What is the major cause of most aneurysms of the abdominal aorta?
A. Excessively elevated serum cholesterol level
B. Marked arteriosclerosis of the aorta
C. Genetic defect of the aortic endothelium
D. Excessive cigarette smoking
E. Obesity

A

B. Marked arteriosclerosis of the aorta

43
Q
This substance dissolves fibrin in blood clots.
A. Plasminogen
B. Plasmin
C. Thromboplastin
D. Thrombin
E. Calcium
A

B. Plasmin

44
Q

According to the American Heart Association, which of the following persons is NOT recommended to receive prophylactic antibiotic treatment before a dental procedure?
A. A 32-year-old woman with a repaired patent ductus arteriosus
B. A 70-year-old man with mild aortic stenosis caused by calcification of the aortic valve due to endocarditis
C. A 37-year-old man who previously had a scarred mitral valve replaced with an artificial heart valve
D. A 55-year-old man with diabetes and angina pectoris

A

D. A 55-year-old man with diabetes and angina pectoris

45
Q
Angina pectoris is usually a manifestation of which of the following?
A. Hypertension
B. Atherosclerosis of coronary arteries
C. Aortic aneurysm
D. Infective (bacterial endocarditis)
E. Stroke
A

B. Atherosclerosis of coronary arteries

46
Q
\_\_\_\_\_\_\_\_\_\_ is a disease in which the air spaces distal to the terminal bronchioles are enlarged and their walls are destroyed.
A. Bronchitis
B. Bronchiectasis
C. Pulmonary emphysema
D. Tuberculosis
E. Bronchial asthma
A

C. Pulmonary emphysema

47
Q

What is one of the effects of splenectomy?
A. Chronic hemolytic anemia
B. Increased susceptibility to systemic bacterial infections
C. Increased likelihood of developing leukemias and lymphomas
D. Pernicious anemia
E. All the above are effects of splenectomy

A

B. Increased susceptibility to systemic bacterial infections

48
Q

Which of the following diseases are considered to be very closely related?
A. Endometrial hyperplasia and in situ carcinoma
B. Cervical dysplasia and endometriosis
C. Cervical dysplasia and in situ carcinoma
D. Salpingitis and condylomas of the genital tract

A

C. Cervical dysplasia and in situ carcinoma

49
Q
Approximately 50-75% of all cases of chronic renal failure result from which of the following?
A. Chronic pyelonephritis
B. Polycystic renal disease
C. Diabetes and hypertension
D. Chronic glomerulonephritis
E. Autoimmune diseases
A

C. Diabetes and hypertension

50
Q

Which of the following does not predispose to kidney stone formation?
A. Increased concentration of salts in the urine
B. Infection of the urinary tract
C. Increased concentration of protein in the urine
D. Urinary tract obstruction

A

C. Increased concentration of protein in the urine

51
Q

Which of the following statements regarding the nephrotic syndrome is correct?
A. Production of plasma proteins by the liver is impaired as a result of kidney disease.
B. Protein is lost in the urine more rapidly than it can be produced by the liver and blood protein falls, which is responsible for the edema.
C. It is usually caused by a bacterial infection of the glomeruli, which impairs glomerular filtration.
D. It is usually caused by renal tubular disease, which prevents reabsorption of protein filtered by the glomeruli.

A

B. Protein is lost in the urine more rapidly than it can be produced by the liver and blood protein falls, which is responsible for the edema.

52
Q

Which of the following does NOT occur as a complication of a kidney stone?
A. Renal colic
B. Kidney infection
C. Hydronephrosis caused by obstruction of urinary drainage by stone impacted in the ureter
D. Glomerulonephritis

A

D. Glomerulonephritis

53
Q

Which of the following is NOT true of Hepatitis C?
A. transmitted by blood and body fluids
B. large doses of gamma globulins protects one after exposure e.g. a needle stick
C. may be unaware you are infected with HCV
D. no vaccine available
E. most common cause is IV drug use

A

B. large doses of gamma globulins protects one after exposure e.g. a needle stick

54
Q

A peptic ulcer is most commonly found in which location?
A. upper esophagus
B. distal small intestine
C. sigmoid colon
D. distal stomach/proximal small intestine
E. throughout the large intestine

A

D. distal stomach/proximal small intestine

55
Q
Which form of hepatitis can only infect those with another form of hepatitis?
A. HAV
B. HBV
C. HCV
D. HDV
E. HEV
A

D. HDV

56
Q

Crohn disease and chronic ulcerative colitis are similar diseases. Several factors seem to be working together to trigger the response that leads to these diseases. Which of the following statements does NOT describe a trigger?
A. Antibiotics sometimes cause these diseases by changing the intestinal bacterial flora.
B. The ability of the immune system to regulate the immune response is impaired.
C. The intestinal epithelium is less able to resist invasion by bacteria.
D. T lymphocyes and cytokines cause the inflammation and necrosis

A

A. Antibiotics sometimes cause these diseases by changing the intestinal bacterial flora.

57
Q

All of the following conditions may lead to hepatic cirrhosis, EXCEPT:
A. excessive alcohol intake.
B. hemochromatosis.
C. hepatitis A virus infection.
D. chronic hepatitis caused by hepatitis B virus.
E. chronic hepatitis caused by hepatitis C virus.

A

C. hepatitis A virus infection.

58
Q
Which of the following forms of viral hepatitis has a diagnostic test available for it and is rarely found in the United States?
A. HEV
B. HDV
C. HCV
D. HBV
E. HAV
A

A. HEV

59
Q
Another name for hyperthyroidism in an adult.
A. cretinism
B. acromegaly
C. myxedema
D. Cushing syndrome
E. Addison disease
A

C. myxedema

60
Q

Which of the following is NOT a physical characteristic of Cushing syndrome?
A. purple striae especially on the trunk
B. large, protruding abdomen
C. “moon face”
D. larger bulk in the arms due to hypertrophied muscle
E. thin skin, easily bruised

A

D. larger bulk in the arms due to hypertrophied muscle

61
Q

The following features characterize hypothyroidism EXCEPT:
A. Decreased levels of TSH
B. Localized accumulation of mucinous material in the skin
C. Decreased levels of thyroid hormones
D. Increased levels of TSH
E. Decreased rate of metabolic processes

A

A. Decreased levels of TSH

62
Q
A(n) \_\_\_\_\_\_\_\_\_\_ hemorrhage occurs when escaping blood accumulates between the outer-most layer of the meninges and the cranial bones.
A. epidural
B. subarachnoid
C. subdural
D. supraarachnoid
E. epipial
A

A. epidural

63
Q
Which of the following is NOT a characteristic feature of Cushing's disease?
A. Osteoporosis
B. Elevated blood glucose
C. Elevated blood cortisol
D. Elevated blood pressure
E. Elevated blood thyroid hormone
A

E. Elevated blood thyroid hormone

64
Q
A(n) \_\_\_\_\_\_\_\_\_\_ hemorrhage/hematoma occurs when escaping blood accumulates between the dura and the arachnoid.
A. epidural
B. subdural
C. subarachnoid
D. epipial
E. subpial
A

B. subdural

65
Q

Which of the following statements regarding a transient ischemic attack (TIA) is INCORRECT?
A. A brief episode of neurologic dysfunction that subsides spontaneously in a short time
B. Often results from embolization of thrombus material or athermous material from an arteriosclerotic plaque in the internal carotid artery
C. Not related to a congenital aneurysm of the circle of Willis
D. Can usually be detected by CT scan of brain

A

D. Can usually be detected by CT scan of brain

66
Q

A transient ischemic attack (TIA) may result from embolization of atheromatous material from an internal carotid artery plaque that lodges in the brain.
True
False

A

True

67
Q

An injured cell may commonly show which of the following changes?
A. Sodium and water diffuse into the cell, causing it to swell and sometimes to rupture.
B. Fat droplets accumulate within the cytoplasm.
C. Cell death, occasionally leading to necrosis.
D. All of the above.
E. None of the above

A

D. All of the above.

68
Q
Which of the following is not a mediator of inflammation?
A. Prostaglandins
B. Histamine
C. Bradykinins
D. Gamma globulin antibodies
E. Products of complement activation
A

D. Gamma globulin antibodies

69
Q

What is the most common cause of metabolic acidosis?

A

The presence of organic acids or excessive ketones in the blood

70
Q

When does metabolic alkalosis occur, and what is the cause?

A

When the blood is too alkaline, due to too much bicarbonate

71
Q

When does respiratory acidosis occur, and what is the cause?

A

When the blood is overly acidic due to an excess of carbonic acid, resulting from too much CO2 in the blood

72
Q

When does respiratory alkalosis occur, and what is the cause?

A

When the blood is overly alkaline, due to a deficiency in carbonic acid and CO2 levels in the blood

73
Q

Excessive cortisol levels, caused by external forces such as glucocorticoid therapy or internal forces such as a tumor producing adrenocorticotropic hormone (ACTH) causing excess cortisol production INDICATES

A

What marker indicates Cushing’s disease, and what is it caused by?

74
Q

Low levels of cortisol and aldosterone, caused by an autoimmune disease that damages the adrenal gland INDICATES

A

Addison’s disease, and what is it caused by?

75
Q

Weight gain (especially in the trunk), high blood pressure, “moon face,” hyperglycemia, a fat pad on the back referred to as a “buffalo hump” INDICATES

A

Cushing’s disease

76
Q

Weight loss, low blood pressure, hypoglycemia, fatigue, and skin hyperpigmentation are symptoms of?

A

What are symptoms of Addison’s disease?

77
Q

What are the risk factors for metabolic syndrome?

A

a. increased blood pressure (greater than 130/85 mmHg)
b. high blood sugar levels (insulin resistance)
c. central obesity
d. high triglyceride levels
e. low levels of good cholesterol (HDL)

78
Q

What is diabetes mellitus?

A

The pancreas doesn’t produce enough insulin to control the amount of glucose in the blood

79
Q

What is diabetes insipidus?

A

Due to pituitary problems, there is a lack of the hormone vasopressin (also called anti-diuretic hormone, or ‘ADH’) from the posterior pituitary, and the kidneys produce a lot of extra urine

80
Q

What is arachidonic acid, and in which food is it most commonly found?

A

A polyunsaturated omega-6 fatty acid that is responsible for muscle tissue inflammation, most commonly found in peanut oil

81
Q

Arachidonic acid leads to an increase in the production of _____ that help raise immunity and inflammatory responses in your body.

A

Eicosanoids

82
Q

_________ are the precursors of red blood cells, platelets, granulocytes (polymorphonuclear leukocytes [PMNs]: neutrophils, eosinophils, and basophils), monocyte-macrophages, dendritic cells (DCs), and mast cells and osteoclasts. They compose a critical arm of the immune system, largely responsible for ______ defense against an array of pathogens

A

Myeloid progenitor cells, innate

83
Q

________ are responsible for the production of immunity mediated by cells or antibodies and including lymphocytes, lymphoblasts, and plasma cells. They originate from the _______, reach the ______, and mature into functional ______.

A

Lymphoid cells, bone marrow, thymus, T cells

84
Q

What is the difference between a sign and a symptom?

A

Symptoms are subjective and apparent only to the patient, while a sign is any objective evidence of a disease that can be observed by others

85
Q

What is pathology?

A

The study of the nature of disease and its causes, processes, development, and consequences

86
Q

What is pathogenesis?

A

The origin and development of a disease; the mechanism whereby something causes a disease

87
Q

What is OPQRST for a chief complaint?

A

Onset of the event; provocation/palliation; quality of the pain; region/radiation; severity; time

88
Q

What is myalgia?

A

Pain in a muscle or group of muscles

89
Q

What is neuralgia?

A

Pain that travels along the length of a nerve

90
Q

What is arthralgia?

A

Inflammation and pain from within the joint itself

91
Q

How are prostaglandins generated, and what blocks their biosynthesis?

A

From arachidonic acid by the action of cyclooxygenase (COX) isoenzymes; blocked by NSAIDs

92
Q

Increased blood flow, chemotaxis (chemical signals that summon white blood cells), and subsequent dysfunction of tissues and organs is caused by?

A

Prostaglandins

93
Q

High concentrations of prostaglandins cause pain by _________. More typically, however, at low concentrations, they ________.

A

Direct action upon nerve endings; markedly increase sensitivity to pain

94
Q

T/F: Prostaglandins are stored, not synthesized as needed, and are slowly metabolized.

A

False

95
Q

For which body systems do prostaglandins help maintain normal function? (4)

A

Cardiovascular, pulmonary, renal, gastrointestinal

96
Q

What are the 5 classical signs of inflammation?

A

Heat, pain, redness, swelling, and loss of function

97
Q

What are the 4 overlapping states of wound healing?

A

1) homeostasis, 2) inflammatory, 3) proliferative, and 4) remodeling

98
Q

What does heparin do, and which cells release it and why?

A

Prevent or arrest clot formation; mast cells release it to stimulate local inflammation

99
Q

Which inflammatory mediator does heparin generate, and via activation of what from the blood coagulation system?

A

Bradykinin; factor XII

100
Q

By regulating the mediators in mast cells, ______ may influence the expression of inflammatory and immunological responses.

A

Heparin

101
Q

What are the major inflammatory mediators? (3)

A

Heparin, histamine, prostaglandins

102
Q

Where is histamine stored, and what stimulates its release?

A

Stored in the granules of mast cells, basophils, platelets; acute inflammation, anaphylatoxins, and histamine releasing factors

103
Q

Histamine is involved in the inflammatory response and has a central role as a mediator of ______. As part of an immune response to foreign pathogens, histamine is produced by ______ and by ______ found in nearby connective tissues.

A

Itching, basophils, mast cells

104
Q

What does prostaglandin production depend on?

A

The activity of prostaglandin G/H synthases (COX-1 and COX-2)

105
Q

_______, expressed constitutively in most cells, is the dominant source of ______ that serve housekeeping functions, such as gastric epithelial cytoprotection and homeostasis. ______, induced by inflammatory stimuli, hormones and growth factors, is the more important source of ________ formation in inflammation and in proliferative diseases, such as cancer.

A

COX-1, prostanoids, COX-2, prostanoid

106
Q

What are the 2 major types of lab biomarkers, and what are they used for?

A

1) Biomarkers of exposure, which are used in risk prediction

2) Biomarkers of disease, which are used in screening, diagnosis, and monitoring of disease progression

107
Q

How does elevated AGE and ALE production lead to cell damage and death?

A

They lead to protein cross-linking and aggregation, resulting in an alteration in cell signaling and functioning

108
Q

What are AGEs and ALEs?

A

Proteins or lipids that become glycated as a result of exposure to sugars

109
Q

______ immunity refers to nonspecific defense mechanisms that come into play immediately or within hours of an antigen’s appearance in the body, activated by chemical properties of the antigen. ______ immunity refers to antigen-specific immune response, created in response to exposure to a foreign substance.

Adaptive
Maladaptive
Innate

A

Innate, Adaptive

110
Q

What is the body’s 1st line of immune defense? Innate or acquired?

A

Physical and chemical barriers, such as skin, mucus membranes, tears, and stomach acid; Innate

111
Q

What is the body’s 2nd line of immune defense? Innate or acquired?

A

Non-specific responses to infection, such as the inflammatory response and complement system; Innate

112
Q
The most selective antimicrobial activity (toxic to bacteria but little or no effect on human cells) would be exhibited by a drug that:
A. inhibits cell wall synthesis.
B. inhibits protein synthesis.
C. injures the plasma membrane.
D. inhibits nucleic acid synthesis.
A

A. inhibits cell wall synthesis.

113
Q

T/F: Endocrine glands discharge their secretions directly into the bloodstream, while secretions from exocrine glands discharge through ducts.

A

True

114
Q

Injury and infection by a pathogenic organism can cause inflammation. What else can cause an inflammatory response?
A. Administration of corticosteroid hormones
B. Excess lysosomes in the cells
C. Interaction of antibodies and antigens
D. No other causes exist
E. Use of NSAIDs

A

C. Interaction of antibodies and antigens

115
Q
Which term describes the changing of a cell to a more resistant type?
A. dysplasia
B. hyperplasia
C. metaplasia
D. hypertrophy
E. apoptosis
A

C. metaplasia

116
Q
Which of the following are considered pre-cancerous conditions?
A. Colon polyps
B. Lentigo maligna
C. Actinic keratoses
D. Leukoplakia
E. All of the above
A

E. All of the above

117
Q
Which molecule is probably the most atherogenic?
A. saturated fat
B. cholesterol
C. LDL
D. triglyceride
E. trans fat
A

E. trans fat

118
Q

Which of the following best describes polycythemia?
A. it is caused by bone marrow dysfunction
B. it has malformed hemoglobin molecules
C. caused by a decreased arterial oxygen saturation by any cause
D. it is a form of leukemia
E. it is identified by small, pale erythrocytes

A

C. caused by a decreased arterial oxygen saturation by any cause

119
Q
The granules of this type of leukocyte contain histamine and heparin.
A. Lymphocyte
B. Neutrophil
C. Eosinophil
D. Basophil
E. Platelet
A

D. Basophil

120
Q

Which of the following conditions is NOT associated with megaloblastic anemia?
A. Vitamin B12 deficiency
B. Folic acid deficiency
C. Iron deficiency
D. Atrophy of gastric mucosa
E. Have decreased numbers of white blood cells

A

C. Iron deficiency

121
Q
What phagocytic white blood cells respond first in inflammatory response to bacteria?
A. Macrophages
B. Eosinophils
C. Neutrophils
D. Lymphocytes
E. Monocytes
A

C. Neutrophils

122
Q
What powerful vasoconstrictor raises the blood pressure by causing the peripheral arterioles to constrict?
A. Renin
B. Angiotensin I
C. Angiotensin II
D. Angiotensin-converting enzyme
E. Aldosterone
A

C. Angiotensin II

123
Q

Which of the following statements about pancreatitis is INCORRECT?
A. Patients who drink excessive amounts of alcohol are prone to pancreatitis.
B. Mild episodes are accompanied by abdominal pain and elevated pancreatic enzymes.
C. This disease develops because the pancreatic islets are incapable of secreting sufficient insulin.
D. Each bout destroys some pancreatic tissue.
E. Often follows gallbladder disease

A

C. This disease develops because the pancreatic islets are incapable of secreting sufficient insulin.

124
Q

All of the following may be associated with hepatic cirrhosis, EXCEPT:
A. portal hypertension.
B. esophageal varices.
C. hepatic encephalopathy.
D. increased arterial and venous blood flow through the liver.
E. ascites.

A

D. increased arterial and venous blood flow through the liver.

125
Q

Which of the following conditions are associated with acute hemorrhagic pancreatitis?
A. Necrosis and inflammation of pancreas and adjacent adipose tissue
B. Activated pancreatic enzymes destroy pancreatic tissue
C. Marked hemorrhage in pancreas resulting from disruption of pancreatic blood vessels by activated enzymes and associated inflammation
D. Severe abdominal pain and tenderness
E. All of the listed conditions are associated with acute hemorrhagic pancreatitis.

A

E. All of the listed conditions are associated with acute hemorrhagic pancreatitis.

126
Q

What is a pathologic fracture?
A. A fracture in which the overlying skin is broken
B. A fracture that occurs in a weakened area of bone secondary to a disease involving the bone
C. A fracture in which the bone is shattered into multiple pieces
D. A fracture associated with an autoantibody
E. It is also known as a comminuted fracture
F. Only A and C

A

B. A fracture that occurs in a weakened area of bone secondary to a disease involving the bone

127
Q

Cells that most commonly active during chronic infections are:
A. Lymphocytes, monocytes, and plasma cells
B. Polymorphonuclear leukocytes, monocytes, and mast cells
C. Complement and bradykinins
D. exudate, transudate, and pus

A

A. Lymphocytes, monocytes, and plasma cells

128
Q
The exudate that occurs during the inflammatory process that consists primarily of fluid containing very little protein is called \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
A. purulent exudate
B. pus
C. serous exudate
D. hemorrhagic exudate
E. extravasation
A

C. serous exudate

129
Q
The most important cell in the acute inflammatory response is an actively phagocytic cell called the \_\_\_\_\_\_\_\_\_\_.
A. mononuclear cell
B. monocyte
C. polymorphonuclear leukocyte
D. macrophage
E. erythrocyte
A

C. polymorphonuclear leukocyte

130
Q
Dysplasia of epithelial cells sometimes results from which of the following?
A. Excessive sodium intake
B. Chronic irritation or inflammation
C. Increased enzyme synthesis
D. Apoptosis
E. Decreased phagocytic activity
A

B. Chronic irritation or inflammation

131
Q
Which of the following is not a member of the cytokine family?
A. interleukin
B. tumor necrosis factor
c. T lymphocyte
d. Interferon
A

c. T lymphocyte

132
Q

Most cases of lobar pneumonia are caused by:
A. staphylococcus aureus.
B. pneumococcus (streptococcus pneumoniae).
C. hemophilus influenzae.
D. group A beta streptococci.

A

B. pneumococcus (streptococcus pneumoniae).

133
Q
Cytokines that send regulatory signals between cells of the immune system are \_\_\_\_\_\_\_\_\_\_.
A. interferon
B. interleukins
C. monokines
D. tumor necrosis factors
E. immunoglobulins
A

B. interleukins

134
Q

Which of the following statements regarding Legionnaire’s disease is correct?
A. It is a virus infection.
B. It is usually spread by direct person-to-person contact.
C. It causes a pulmonary infection.
D. Organisms live in the soil
E. Usually carried by the mosquito

A

C. It causes a pulmonary infection.

135
Q
\_\_\_\_\_\_\_ immunity is characterized by the formation of a population of lymphocytes that can attack and destroy the foreign material.
A. Acquired
B. Humoral
C. Cell-mediated
D. Hypersensitive
E. Innate
A

C. Cell-mediated

136
Q
\_\_\_\_\_\_\_\_\_ immunity is associated with the production of antibodies that can combine and eliminate the foreign material.
A. T-cell mediated
B. Humoral
C. Cell-mediated
D. Hypersensitive
E. Passive
A

B. Humoral

137
Q

Most of the lymphocytes in the circulation would be classified as what?
A. T lymphocytes
B. B lymphocytes
C. Neither T nor B lymphocytes (natural killer cells, also called NK cells)
D. Macrophages
E. Mast cells

A

A. T lymphocytes

138
Q
John Jones was exposed to a person who was ill with an infectious disease, and John received an injection of globulin to provide protection against the infectious agent to which he was exposed. What is the class of antibody in the gamma globulin that provides the protection?
A. IgG
B. IgA
C. IgM
D. IgD
E. IgE
A

A. IgG

139
Q

One method the body uses to destroy bacteria is by forming a membrane attack complex that produces perforations in the walls of bacterial cells and enveloped viruses, thereby causing their destruction. What is the substance producing the membrane attack complex?
A. Interferon
B. Lymphokines produced by T lymphocytes
C. Gamma globulin produced by B lymphocytes
D. Complement
E. Antibodies

A

D. Complement

140
Q
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ inhibit the multiplication of viruses that have infected a cell.
A) natural killer cells
B) tumor necrosis factor
C) interferons
D) B lymphocytes
E) T lymphocytes
A

C) interferons

141
Q
Which type of hypersensitivity reaction causes tissue injury by the formation of immune complexes?
A. Type I
B. Type II
C. Type III
D. Type IV
A

C. Type III

142
Q
This disease is known for its characteristic malar (butterfly rash) and causes damage to skin, joint tissues, heart, and kidneys.
A. rheumatoid arthritis
B. myasthenia gravis
C. lupus erythematosus
D. scleroderma
E. Grave's disease
A

C. lupus erythematosus

143
Q

An angioma is a
A. benign tumor projecting from an epithelial surface
B. malignant tumor of bone
C. malignant tumor arising from epithelial cells
D. benign blood vessel tumor
E. benign tumor of cartilage

A

D. benign blood vessel tumor

144
Q

How does our immune system protect us from cancer?
A. It recognizes and destroys abnormal cells, which differ from normal cells.
B. Lymphocytes block lymphatic channels so that tumor cells cannot metastasize through the lymphatics.
C. Proliferation of T lymphocytes declines in response to tumor growth.
D. It destroys viruses that promote tumor growth.
E. Phagocytes engulf the bacteria that cause cancer

A

A. It recognizes and destroys abnormal cells, which differ from normal cells.

145
Q
Which of these is a benign smooth muscle tumor of the uterus?
A. Adenoma
B. Myoma
C. Carcinoma
D. Sarcoma
E. Glioma
A

B. Myoma

146
Q

Malignant tumor cells do not wear out and die as normal cells do, but instead they __________.
A. must be killed by high-level immune response
B. grow rapidly and transform the tissue around them
C. become immortal and proliferate indefinitely
D. die only when they have achieved dominance in the tissue that formed them originally

A

C. become immortal and proliferate indefinitely

147
Q
This is a neoplasm of bone marrow that causes weakness of bones.
A. Hodgkin's lymphoma
B. acute leukemia
C. Wilm's tumor
D. retinoblastoma
E. multiple myeloma
A

E. multiple myeloma

148
Q

T/F A tumor by definition is always malignant.

A

False

149
Q

T/F: A pregnant woman with phenylketonuria does not need to adhere to a phenylalanine-restricted diet because the high concentration of phenylalanine in the woman’s blood does not harm the fetus.

A

False

150
Q

Which of the following statements is correct?
A. A hormone-dependent tumor is one that produces sex hormones.
B. Chemotherapy attempts to destroy subclinical micrometastases that have already spread from the primary tumor.
C. Mutations caused by viruses, chemicals, radiation or other agents do not disturb cell function and do not predispose to tumors.
D. Radiotherapy is always used with surgery for malignant tumors since surgical removal cannot be assured of total removal of the tumor

A

B. Chemotherapy attempts to destroy subclinical micrometastases that have already spread from the primary tumor.

151
Q
A malignant tumor arising from glands within the lining of the uterus is a/an \_\_\_\_\_\_\_\_\_\_.
A. adenocarcinoma
B. myosarcoma
C. myoma
D. polyp
E. angioma
A

A. adenocarcinoma

152
Q
A malignant tumor of connective tissue is called a(n):
A. adenoma
B. carcinoma
C. papilloma
D. sarcoma
E. lymphoma
A

D. sarcoma

153
Q
Which of these is a benign tumor of fat cells?
A. Adenocarcinoma
B. Lipoma
C. Liposarcoma
D. Lymphosarcoma
E. Leukemia
A

B. Lipoma

154
Q
The most likely place for a thrombosis to form postoperatively is:
A. the lungs.
B. the left side of the heart.
C. the leg veins.
D. anywhere in the body.
E. the small leg arteries
A

C. the leg veins.

155
Q
Which of the following does NOT cause embolisms?
A. Air
B. Fat
C. Amnionic fluid
D. Bacteria
E. Injected crushed narcotic tablets
A

D. Bacteria

156
Q
Which substance found in the blood is most sensitive for detecting a recent myocardial infarction?
A. C-reactive protein
B. creatine kinase
C. troponin T
D. homocysteine
E. triglycerides
A

C. troponin T

157
Q

Which statement about platelets is not true?
A. They plug the defect in the vessel wall.
B. They liberate chemical compounds that cause the vessel to contract.
C. They release phospholipids that initiate the process of blood coagulation
D Are removed from circulation in the spleen.
E. All of the above are true

A

E. All of the above are true

158
Q

T/F: Pitting edema most frequently occurs in left heart failure.

A

False

159
Q

Which of the following conditions does not predispose to edema?
A. Heart failure
B. Von Willebrand’s factor deficiency
C. Increased capillary permeability
D. Low plasma osmotic pressure resulting from low blood proteins
E. Lymphatic obstruction

A

B. Von Willebrand’s factor deficiency

160
Q
This type of shock is a complication of a heart attack:
A. hypovolemic
B. cardiogenic
C. anaphylactic
D. septic
E. electrical
A

B. cardiogenic

161
Q
A disturbance of blood coagulation caused by a deficiency of prothrombin or related factors suggests does NOT include which of the following?
A. Administration of anticoagulant drugs
B. Inadequate synthesis of vitamin K
C. Severe liver disease
D. Inadequate absorption of vitamin K
E. Inadequate iron intake.
A

E. Inadequate iron intake.

162
Q
This substance is released into the blood during an acute inflammatory event.
A. homocysteine
B. folic acid
C. LDL
D. CRP
E. heparin
A

D. CRP

163
Q
Which of the following substances increases the risk of thromboembolic disease?
A. Aspirin
B. Coumadin drugs
C. Oral contraceptives
D. Diet pills
E. Heparin
A

C. Oral contraceptives

164
Q
In phase 2 of the blood coagulation process, \_\_\_\_\_\_\_\_\_\_ is converted into \_\_\_\_\_\_\_\_\_\_.
A. thromboplastin; thrombin
B. prothrombin; thrombin
C. fibrinogen; fibrin
D. thrombin; prothrombin
A

B. prothrombin; thrombin

165
Q
Digitalis (digoxin) is often used to treat which condition?
A. atrial fibrillation
B. complete heart block
C. rheumatic fever
D. mitral regurgitation
E. ventricular fibrillation
A

A. atrial fibrillation

166
Q

T/F: An elevated CRP test in an otherwise normal person without evidence of an infection predicts an increased long-term risk of cardiovascular disease by identifying the inflammatory changes associated with accumulation of macrophages and other inflammatory cells in an unstable atheromatous coronary artery plaque.

A

True

167
Q
Which of the following is not a frequent complication of a myocardial infarction?
A. heart failure
B. arrhythmias
C. formation of mural thrombi
D. rupture of the heart
E. mitral valve prolapse
A

E. mitral valve prolapse

168
Q
Blood will not clot in the absence of this substance.
A. potassium
B. calcium
C. vitamin C
D. plasmin
E. vitamin D
A

B. calcium

169
Q
Antidiuretic hormone (ADH) is released in response to:
A. Decreased serum osmolality
B. Increased serum osmolality
C. Decreased urinary urea nitrogen
D. Increased urinary urea nitrogen
A

B. Increased serum osmolality